Patel Palak R, Armistead-Jehle Patrick, Eltman Nicholas R, Heath Kelly M, Cifu David X, Swanson Randel L
Department of Physical Medicine and Rehabilitation, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA USA.
Munson Army Health Center, Concussion Clinic, Fort Leavenworth, KS USA.
Curr Phys Med Rehabil Rep. 2023;11(3):367-376. doi: 10.1007/s40141-023-00413-7. Epub 2023 Jul 5.
Individuals with a history of traumatic brain injury (TBI) are at a much greater risk for developing cardiovascular disease (CVD) compared to the general population. This review discusses dietary patterns as a means of addressing modifiable risk factors following TBI exposure. Evidence-based resources for practicing Physiatrists and Brain Injury Medicine specialists pertaining to nutrition education and counseling are also provided.
We examined Mediterranean, Dietary Approaches to Stop Hypertension, plant-based, ketogenic, and intermittent fasting dietary patterns through publications of clinical trials and systematic reviews. While many reviews had significant positive findings, some were limited by generalizability.
While there is extensive literature on the immediate nutrition goals in the inpatient setting following an acute TBI exposure, there is limited literature discussing the nature of diet and nutrition in the post-acute setting. Fortunately, most individuals with TBI exposure survive their initial injury and continue into the recovery phase. The scientific literature supports increased morbidity and mortality with chronic TBI exposure compared to matched counterparts, most notably with CVD. A diet rich in fiber and nutrients but limited in added sugars, saturated fats, and excess calories would likely have the greatest cardiovascular and related neurologic protection. Future studies are needed to assess the specific impact of dietary interventions in the chronic phase of brain injury recovery.
与普通人群相比，有创伤性脑损伤（TBI）病史的个体患心血管疾病（CVD）的风险要高得多。本综述讨论饮食模式，将其作为TBI暴露后应对可改变风险因素的一种方式。还为从事物理医学与康复的医生和脑损伤医学专家提供了有关营养教育和咨询的循证资源。
我们通过临床试验和系统评价的出版物，研究了地中海饮食、得舒饮食、植物性饮食、生酮饮食和间歇性禁食饮食模式。虽然许多综述有显著的阳性结果，但有些受到可推广性的限制。
虽然有大量关于急性TBI暴露后住院患者即时营养目标的文献，但讨论急性后期饮食和营养性质的文献有限。幸运的是，大多数TBI暴露患者在初次受伤后存活下来并进入康复阶段。科学文献表明，与匹配的对照组相比，慢性TBI暴露会增加发病率和死亡率，最明显的是心血管疾病。富含纤维和营养但添加糖、饱和脂肪和热量过多受限的饮食可能对心血管和相关神经具有最大的保护作用。未来需要开展研究，以评估饮食干预在脑损伤恢复慢性期的具体影响。
